Background

Kenya has shown progress in social, economic, and health indicators over the past 2 decades. Yet, malnutrition remains a critical public health issue. Effective Multisectoral Nutrition Governance (MNG) is an enabling determinant of nutrition ensures that nutrition policies are well-coordinated, adequately funded, and effectively implemented, leading to better nutrition outcomes.

Objective

Our study assessed the status, evolution, and factors associated with MNG in Kenya using a cross-sectional design at 2 distinct time points (2012 and 2023). The 2 distinct time points provided valuable comparative perspectives allowing for the assessment of progress and trends in MNG allowing further analysis.

Methods

The study targeted 96 government and nongovernmental staff from eligible ministries at the national level. It used a structured closed-ended questionnaire adapted from a validated Nutrition Governance Index.

Results

Our findings reveal an improvement in MNG status, from 58.4% in 2012 to 71.1% in 2023 (P < .01). The 6 MNG domains demonstrated varying performance levels, with mean scores ranging from 3.1 to 4.0 (out of 5). Despite the performance variation, the domains contributed equally to the MNG status. A positive relationship was found between the MNG score and respondent affiliation with the Ministry of Health and the level of prioritization of nutrition in a ministry (P < .05).

Conclusions

Further efforts are needed to strengthen specific MNG domains, particularly nutrition financing, transparency, accountability, and capacity, to ensure progress in tackling malnutrition in Kenya. These findings can inform efforts to enhance MNG strategies to improve nutrition outcomes sustainably in Kenya.

Plain language title

Study to Assess the Status of Effective Governance for Delivering Multisectoral Nutrition Programs in Kenya and Identify Factors that Influence Its Effectiveness

Plain language summary Why was the study done?

Malnutrition remains a significant public health challenge in Kenya despite improvements in some nutrition indicators such as stunting. More effort across various sectors is required to sustain progress in some areas and address gaps in areas in which the country is off-track. Ensuring nutrition programs are effectively planned, managed, and implemented across different sectors requires strong/good governance. However, little is known about how well governance structures support multisectoral nutrition programs in Kenya and what factors contribute to their effectiveness. This study aimed to assess the status of governance for nutrition programs and identify key factors that influence its success over the past decade.

What did the researchers do?

The research team surveyed 96 government and nongovernment officials from 8 different ministries using a standardized questionnaire to understand how governance for nutrition programs was functioning. The questionnaire covered nutrition governance constituents/domains such as leadership, coordination, financing, and capacity to deliver nutrition programs. They compared nutrition governance effectiveness over the past 10 years (2023 and 2012). They also analyzed factors that may influence nutrition governance such as stakeholder roles, the specific government ministries they work for/support, and number of years they have worked in their sectors.

What did the researchers find?

The findings showed that nutrition governance improved from 58.4% in 2012 to 71.1% in 2023. Governance domains such as enhanced political commitment and leadership for nutrition, adoption of nutrition policy frameworks, and improved coordination observed the greatest improvements. Nutrition financing, accountability, and capacity to deliver nutrition are some of the areas that require improvement. Furthermore, the findings showed that respondents from ministries that placed a higher priority on nutrition and those linked to the Ministry of Health had higher governance scores.

What do the findings mean?

This study highlights areas where governance for nutrition programs has improved and where further work is needed. Strengthening nutrition financing, improving accountability, and strengthening capacity are essential to sustaining progress and ensuring that multisectoral nutrition programs are effectively delivered in Kenya. These findings can guide policymakers in refining governance strategies to ensure long-term improvements in nutrition outcomes across the country.